<?php
$attributes = array('class' => 'form-horizontal');
echo form_open("website/thanhvien/registration/submit_registration", $attributes);
?>
<br><br><br>

<div class="modal fade bs-example-modal-lg" tabindex="-1" role="dialog" aria-labelledby="myLargeModalLabel" aria-hidden="true">
    <div class="modal-dialog modal-sm" style="width: 690px;">
        <div class="panel panel-primary">
            <!--<div class="form-group row">-->

            <div class="panel-heading" style="height: 45px !important;">
                <h5><b>Tạo tài khoản với Map Center</b></h5>
            </div>
            <br>
            <div style="text-align: center; font-size: 1em; color: red;">
                <label>Thông tin tài khoản</label>
            </div>

<!--            <div class="col-xs-1"></div>-->
            <div class="col-xs-11">
                <div class="form-group row">
                    <div class="col-xs-1"></div>
                    <div class="col-xs-3">
                        <label class="control-label" for="email_address">Email</label>
                    </div>
                    <div class="col-xs-8">
                        <input type="email" id="email_address" Class="form-control" placeholder="Email..."
                               name="email_address" value="<?php echo set_value('email_address'); ?>" />
                               <?php echo form_error('email_address', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
                    </div>
                </div>
                <div class="form-group row">
                    <div class="col-xs-1"></div>
                    <div class="col-xs-3">
                        <label class="control-label" for="email">Confirm email</label>
                    </div>                        
                    <div class="col-xs-8">
                        <input type="email" id="con_email" Class="form-control" placeholder="Nhập lại Email ..."
                               name="con_email" value="<?php echo set_value('con_email'); ?>" />
                               <?php echo form_error('con_email', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
                    </div>
                </div>
                
                <div class="form-group row">
                    <div class="col-xs-1"></div>
                    <div class="col-xs-3">
                        <label class="control-label" for="user_name">Username</label>
                    </div>
                    <div class="col-xs-8">
                        <input type="text" id="username" Class="form-control" placeholder="Tên đăng nhập của bạn..."
                               name="username" value="<?php echo set_value('username'); ?>" />
                               <?php echo form_error('username', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
                    </div>
                </div>
                
                <div class="form-group row">
                    <div class="col-xs-1"></div>
                    <div class="col-xs-3">
                        <label class="control-label" for="password">Password</label>
                    </div>
                    <div class="col-xs-8">
                        <input type="password" id="password" Class="form-control" placeholder="Mật khẩu ..."
                               name="password" value="<?php echo set_value('password'); ?>" />
                               <?php echo form_error('password', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
                    </div>

                </div>
                <div class="form-group row">
                    <div class="col-xs-1"></div>
                    <div class="col-xs-3">
                        <label class="control-label" for="con_password">Confirm password</label>
                    </div>
                    <div class="col-xs-8">
                        <input type="password" id="con_password" Class="form-control" placeholder="Nhập lại mật khẩu..."
                               name="con_password" value="<?php echo set_value('con_password'); ?>" />
                               <?php echo form_error('con_password', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
                    </div>
                </div>
                
                <div class="form-group row">
                    <div class="col-xs-1"></div>
                    <div class="col-xs-3">
                        <label class="control-label" for="sexual">Giới tính</label>
                    </div>
                    <div class="col-xs-8">
                        <select type="text" id="sexual" Class="form-control"  name="sexual">
                            <option value="0">Nam</option>
                            <option value="1">Nữ</option>
                            <option value="2">Khác</option>
                        </select>
                        <?php echo form_error('sexual', '<p class="text-danger" style="font-size:15px;">', '</p>'); ?>
                    </div>
                </div>
            </div>

            <!--</div>-->

            <div class="form-group" style="padding-top: 50px;">
                <div class="col-xs-4"></div>
                <div class="col-xs-4">
                    <button type="submit" class="btn btn-primary btn-lg btn-block" >Đăng ký</button>
                </div>



            </div>

            <?php echo form_close(); ?>
        </div>
    </div>
</div>

